Normal breath sounds are breezy, low pitched sounds with a lengthy inspiratory phase and a shorter expiratory phase. Normal breath sounds heard over the posterior lung fields are also called vesicular breath sounds. When heard, they can also be documented as clear lung sounds. Normal Breath Sounds
Adventitious Breath Sounds
Adventitious breath sounds are heard over normal breath sounds. They are either discontinuous, popping sounds (crackles), or continuous, musical sounds (wheezes). Other terms, rales and rhonchi, are often used to describe adventitious breath sounds, but with inconsistent meanings.
Williams and Hopper (Understanding Medical-Surgical Nursing) use these terms Fine Crackles Coarse Crackles Wheezes Stridor Pleural Friction Rub
Wilkinson and Leuven (Fundamentals of Nursing) use the terms Crackles Rhonchi Wheezes Stridor Stertor
To remain consistent, adventitious sounds that are discontinuous will be referred to as crackles and adventitious sounds that are continuous will be referred to as wheezes.
Crackles
Crackles are discontinuous sounds made by the sudden popping open of collapsed or fluid filled small bronchioles or the alveoli. Fine crackles can be likened to the sound of hair rubbing together or a fire crackling in the distance. When present, fine crackles are almost always heard at the latter part of inspiration. Crackles caused by fluid are more moist. Moist, or bubbly, crackles can be heard either during inspiration or expiration or both. Crackles are often heard in a patient with COPD or atelectasis. Crackles
Coarse Crackles are caused by air moving over secretions. The patient exhibiting coarse crackles has pulmonary congestion. The speaker in the video refers to coarse crackles as rhonchi. Some nurses use the term rhonchi to refer to wheezes. Many nurses use the term rales to refer only to coarse crackles, but not to fine crackles. In keeping with your Med Surg textbook definitions, the term coarse crackles is being used. As you watch the next video, think of these sounds as coarse crackles rather than rhonchi. Coarse Crackles
Wheezes
Wheezes are caused by air moving through constricted airways. Constricted airways occur as a result of bronchoconstriction, fluid narrowing the lumen of the airways, or a combination of both. Wheezes are musical sounds, and can be either a high pitched whistle or a low pitched whistle. Wheezes of one tone are referred to as monophonic. Wheezes of different tones is referred to as polyphonic. Wheezes can occur during the expiratory phase, the inspiratory phase, or both phases. Random wheezes are wheezes that occur sporadically throughout the respiratory phases. Wheezes
Stridor
Stridor is caused by severe narrowing of the airways. This narrowing can be the result of bronchoconstriction, mechanical obstruction (choking), or tumor. Stridor can be heard without a stethoscope. Stridor is sometimes likened to the sound made by a crow.
Lung Sounds
Normal Breath Sounds
Normal breath sounds are breezy, low pitched sounds with a lengthy inspiratory phase and a shorter expiratory phase. Normal breath sounds heard over the posterior lung fields are also called vesicular breath sounds. When heard, they can also be documented as clear lung sounds.Adventitious Breath Sounds
Adventitious breath sounds are heard over normal breath sounds. They are either discontinuous, popping sounds (crackles), or continuous, musical sounds (wheezes). Other terms, rales and rhonchi, are often used to describe adventitious breath sounds, but with inconsistent meanings.Williams and Hopper (Understanding Medical-Surgical Nursing) use these terms
Wilkinson and Leuven (Fundamentals of Nursing) use the terms
Taber's Dictionary describes
To remain consistent, adventitious sounds that are discontinuous will be referred to as crackles and adventitious sounds that are continuous will be referred to as wheezes.
Crackles
Crackles are discontinuous sounds made by the sudden popping open of collapsed or fluid filled small bronchioles or the alveoli. Fine crackles can be likened to the sound of hair rubbing together or a fire crackling in the distance. When present, fine crackles are almost always heard at the latter part of inspiration. Crackles caused by fluid are more moist. Moist, or bubbly, crackles can be heard either during inspiration or expiration or both. Crackles are often heard in a patient with COPD or atelectasis.Coarse Crackles are caused by air moving over secretions. The patient exhibiting coarse crackles has pulmonary congestion. The speaker in the video refers to coarse crackles as rhonchi. Some nurses use the term rhonchi to refer to wheezes. Many nurses use the term rales to refer only to coarse crackles, but not to fine crackles. In keeping with your Med Surg textbook definitions, the term coarse crackles is being used. As you watch the next video, think of these sounds as coarse crackles rather than rhonchi.
Wheezes
Wheezes are caused by air moving through constricted airways. Constricted airways occur as a result of bronchoconstriction, fluid narrowing the lumen of the airways, or a combination of both. Wheezes are musical sounds, and can be either a high pitched whistle or a low pitched whistle. Wheezes of one tone are referred to as monophonic. Wheezes of different tones is referred to as polyphonic. Wheezes can occur during the expiratory phase, the inspiratory phase, or both phases. Random wheezes are wheezes that occur sporadically throughout the respiratory phases.Stridor
Stridor is caused by severe narrowing of the airways. This narrowing can be the result of bronchoconstriction, mechanical obstruction (choking), or tumor. Stridor can be heard without a stethoscope. Stridor is sometimes likened to the sound made by a crow.More Lung Sounds Online
Recognizing Adventitious Lung Sounds